Report 2013-116 Recommendation 5 Responses

Report 2013-116: Los Angeles County: Lacking a Comprehensive Assessment of Its Trauma System, It Cannot Demonstrate That It Has Used Measure B Funds to Address the Most Pressing Trauma Needs (Release Date: February 2014)

Recommendation #5 To: Los Angeles County

To ensure that it allocates Measure B funds to address the most significant needs of residents within its trauma system, the board should reinstate a Measure B oversight committee, with participation from departments with trauma, EMS, and bioterrorism preparedness expertise, as well as representatives of the public. The oversight committee should review trauma system and other county needs annually and advise the board on Measure B expenditures. As part of its responsibilities, the oversight committee should reevaluate the Measure B allocation approach, taking into consideration the results of Los Angeles's comprehensive assessment and the effects of the Act, and issue a report on its findings no later than December 2015.

Annual Follow-Up Agency Response From October 2016

The Los Angeles County Board of Supervisors will continue to serve as the advisory and approval body with respect to distribution of Measure B funds.

As a follow-up to last year's response regarding distribution of funds to non-County trauma hospitals, Los Angeles County, through its Department of Health Services, has met regularly with hospital representatives to collaboratively share ideas and concepts for allocating available funds, including Measure B, to support the trauma network. The group has developed guiding principles centered around preserving and supporting the County-wide trauma network for the uninsured and underinsured population, providing assistance with covering fixed costs for trauma-related infrastructure, and taking into account patient acuity and managed care changes. The group feels it is necessary to maintain a stable allocation of funds to ensure the stability of the trauma network instead of trying to reallocate funds annually, which could serve to undermine long-term planning efforts for the trauma network participants. This group will continue to meet on an ongoing basis and will serve as an important voice in developing overall recommendations to the LA County Board of Supervisors.

California State Auditor's Assessment of Annual Follow-Up Status:
Will Not Implement

Annual Follow-Up Agency Response From September 2015

Los Angeles County - Department of Health Services is working with the Board regarding the preferred process for evaluating, establishing, and reporting on the Measure B allocation approach, including consideration of a proposed revised methodology to allocate Measure B dollars to non-County hospitals, and analysis of the impact of the new methodology on the trauma system.

The reason for not fully implementing the recommendation is that additional time is needed to collect and validate relevant data from trauma hospitals, complete the analysis of data submitted, discuss findings with trauma hospitals, and develop and present potential recommendations to the LA County Board of Supervisors.

1-Year Agency Response

LA County Dept. of Health Services will discuss with the Board the preferred process for evaluating, establishing, and reporting on the Measure B allocation approach, including consideration of the impact of the Affordable Care Act (ACA) on such allocation.

Estimated Completion Date: August 2015

Response Date: February 2015

California State Auditor's Assessment of 1-Year Status:
No Action Taken

6-Month Agency Response

DHS will discuss with the Board the preferred process for evaluating, establishing, and reporting on the Measure B allocation approach, including consideration of the impact of the Affordable Care Act on such allocation.

Estimated Completion Date: November 2014

Response Date: August 2014

California State Auditor's Assessment of 6-Month Status:
No Action Taken

60-Day Agency Response

The County's Health Services Department will work with the Board to consider establishment of an Advisory Committee to evaluate and advise Measure B allocation, assess the impact of the Patient Protection and Affordable Care Act on the trauma care system, and prepare reports as requested by the Board.

Estimated Completion Date: TBD

Response Date: April 2014

California State Auditor's Assessment of 60-Day Status:
No Action Taken